非アルコール性ステア肝炎: レビュー
Adam C Sheka1, Oyedele Adeyi2, Julie Thompson3
1Department of Surgery, University of Minnesota, Minneapolis.
JAMA
|March 25, 2020
まとめ
非アルコール性脂肪肝炎 (NASH) は 肥満と糖尿病に関連して 認知されていない 肝臓疾患です 早期発見と体重減少を含む生活習慣の変化は,NASHの管理と肝硬変や移植などの重篤な結果の予防に不可欠です.
科学分野:
- ヘパトロジー
- 内科 医学
- 公衆衛生
背景:
- 非アルコール性脂肪肝炎 (NASH) は,非アルコール性脂肪肝疾患 (NAFLD) の炎症的形態であり,しばしば肝硬変と肝臓移植に進行する.
- NASHは米国の人口の3~6%に感染し,肥満,脂質不全,第2型糖尿病,代謝症候群に関連した流行が増加しています.
- その臨床的意義にもかかわらず,NASHは認識されていないまま,肝臓生検が唯一の診断基準です.
研究 の 目的:
- NASHの有病率と臨床的重要性を強調する.
- NASHの早期発見と標的型管理戦略の必要性を強調する.
- NASHと関連する代謝疾患の管理におけるライフスタイル変更と減量手術の重要性を強調する.
主な方法:
- NASHの流行と危険因子に関する現在の疫学データのレビュー.
- 肝臓生検の役割を含む診断上の課題と限界の分析
- ライフスタイルの変更と外科的介入に焦点を当てた現在の治療パラダイムの検討
主要な成果:
- 米国の人口の3~6%にNASHが影響し,罹患率は上昇しています.
- 肥満,脱脂症,2型糖尿病,代謝症候群は主要な関連疾患である.
- NASH患者の約20%が肝硬変を発症し,死亡率は著しく上昇します.
結論:
- NASHの早期発見と標的型治療は,患者のアウトカムを改善するために不可欠です.
- 体重減少を促進する集中的なライフスタイルの変更が主な治療方法です.
- NASH患者における肥満および代謝疾患の管理には,腹腔外科手術が推奨される.
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